One marginal Covid-19 and Fast Grants update

A number of scientists (including, but not only, those funded by Fast Grants) have reported some interesting findings related to fluvoxamine, SSRIs and sigma-1 receptor (S1R) agonists more broadly.

  • A small RCT at Washington University (n=152) published in JAMA found that patients receiving fluvoxamine had a 0% hospitalization rate (vs. 8.3% for placebo). https://jamanetwork.com/journals/jama/fullarticle/2773108
  • Another group reported (data not yet published but reported here with permission) a 0% hospitalization rate in a fluvoxamine-treated cohort compared to 11% in the non-treated group. (n=146)
  • A large observational analysis (n=7345) of hospitalized French patients found that those on SSRIs (of which fluvoxamine is one) had a very substantially reduced risk of death. (n=257, HR = 0.56.). SSRIs with the highest Sigma1 activation showed the greatest protection. https://www.medrxiv.org/content/10.1101/2020.07.09.20143339v2
  • Fluvoxamine is a potent sigma-1 receptor agonist. Following their initial report on the role of S1R in SARS-CoV2 – host interaction, Nevan Krogan’s group found that patients receiving another sigma-1 agonist (indomethacin) had a materially reduced likelihood of requiring hospitalization compared to those receiving celecoxib, which doesn’t activate sigma-1. This work was supported by Fast Grants. https://science.sciencemag.org/content/370/6521/eabe9403.full
  • Lastly, a genetic screen by a Fast Grants-funded lab (not yet published but reported here with permission) has found that genes upregulated by fluvoxamine significantly inhibit SARS-CoV2 mediated cell death.

On the off chance there is something here, fluvoxamine is relatively safe, cheap, and widely available.  We are very open to both positive and negative data in this area, and have funded a further effort.  Do let us know if you hear anything on this topic!

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